DEPRESSION MODULATES PRURITUS PERCEPTION - A STUDY OF PRURITUS IN PSORIASIS, ATOPIC-DERMATITIS, AND CHRONIC IDIOPATHIC URTICARIA

Pruritus, or itching, is the most common symptom of dermatologic disea se. Psychologic factors can affect pruritus, and in an earlier study o f inpatients with moderate to severe psoriasis, we observed that the d egree of depressive psychopathology directly correlated with pruritus severity. In this study we investigated the relation between pruritus and depression among a group of patients (N = 252) with a wide range o f pruritic skin disorders, including outpatients with mild to moderate psoriasis (N = 77), atopic dermatitis (N = 143) and chronic idiopathi c urticaria (N = 32). All patients self-rated the severity of their pr uritus on a 10-point scale and completed a battery of psychologic rati ngs, including the Carroll Rating Scale for Depression (CRSD). We obse rved a direct correlation (Pearson's r =.34, p <.0001) between pruritu s severity and the CRSD score. The correlations between pruritus sever ity and CRSD scores for each individual diagnostic group were as follo ws: psoriasis: Pearson's r =.32, p =.004; atopic dermatitis: Pearson's r =.21, p =.013; and chronic idiopathic urticaria: Pearson's r =.34, p =.06. When the subjects with pruritus scores less than 5.5 were comp ared with subjects with pruritus scores greater than 5.5, significant differences (p <.05) in depression scores were found for all three der matoses by the Mann-Whitney U test. The depressed clinical state may r educe the threshold for pruritus.